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November 11, 2008

Google joins the CDC in tracking our health

Did you hear that Google is working with the federal government to track our health based on our online searches?

Google tracks trends of search terms people use when looking for online health information. It found that people search for flu-related topics commonly during flu season. Google software engineers, Jeremy Ginsberg and Matt Mohebb, said they then tallied the flu-related searches users made for each day and region of the country and compared it to data from the surveillance system managed by the U.S. Centers for Disease Control and Prevention. The CDC monitors disease outbreaks using data collected every week from state health departments, based on actual records from doctors and laboratory pathology reports of patients diagnosed with infectious diseases. Google found a very close relationship between internet activity and CDC reports.

The Google team said it was able to identify trends within days, one to two weeks earlier than CDC’s published reports. “Our up-to-date influenza estimates may enable public health officials and health professionals to better respond to seasonal epidemics and — though we hope never to find out — pandemics,” says Google. “If a new strain of influenza virus emerges under certain conditions, a pandemic could emerge and cause millions of deaths,” as happened in 1918, they said.

Their next step, they said: “We shared our preliminary results with the Epidemiology and Prevention Branch of the Influenza Division at CDC throughout the 2007-2008 flu season, and together we saw that our search-based flu estimates had a consistently strong correlation with real CDC surveillance data.”

So, Google and the CDC have collaborated, and Google’s new tool called Google Flu Trends will monitor our online search trends and publish a map of "affected" areas as part of its new service. “Our system is still very experimental, so anything is possible,” said Ginsberg and Mohebb, “but we're hoping to see similar correlations in the coming year.” No word yet on what those might be (STDs, HIV, alcoholism, obesity...?).

Larger implications

The public health implications of this system will be published in an upcoming issue of the journal Nature (unavailable yet, stay tuned). Whether Google’s monitoring of users’ internet activities will actually prove to accurately reflect disease outbreaks has yet to be demonstrated, but epidemiologists are already skeptical.

ABC News interviewed Stephen Morse, Ph.D., an epidemiologist of infectious diseases at Columbia University's Mailman School of Public Health, who said he could think of a lot of reasons why people would search for information on the flu. He, himself, goes online searching for flu information all the time, he said, but he isn’t sick. Another problem is that the public uses very different terms for health topics than medical professionals do, which could easily result in incorrect assumptions.

It’s also an idea that’s ripe for manipulation. All it would take is another scare of the day health story in the news to spur people to go online to learn more or an internet urban legend scare bomb dropped at social media websites to create a buzz of internet activity on the topic. Poof! A disease outbreak and justification for public health agencies to intervene. More importantly, for marketing interests it step in. The marketing potential of such information will be irresistible.

As an early warning system of infectious diseases, using the pandemic of 1918 to promote it is a stretch. While the word “pandemic” strikes fear into the hearts of consumers, most of us have lived through a pandemic and probably weren’t even aware of it. The last flu pandemic was in 1968 and killed 33,800 Americans — about the number who die from the flu in an average year. Using the example of a pandemic of infectious disease and the protection of public health and safety to justify government agencies monitoring internet activity is just the opening salvo to a slipper slope of political and commercial possibilities for misuse.

Nanny watch?

Professor Morse hinted at the larger potentials for misuse of Google’s new system, when he observed that this novel method could be used to observe and track human behaviors, to aid in the fight of disease. Given the new CDC’s focus on consumers’ diets and lifestyle behaviors, believing them the cause of chronic diseases of aging, and the basis of federal preventive public health programs against declared epidemics of obesity and diabetes, the possibilities for government surveillance are endless.

Looking for too many cookie cookbooks, fast food coupons or take-out menus; sharing decadent chocolate cake recipes; mail ordering fatty meat and sausages or candy; participating in a smoker’s rights forum; downloading too many home videos; or spending too many hours online… when you should be dieting and exercising?

Such considerations are not beyond possibilities for monitoring health behaviors.

Drudge reports that Google’s chief executive vowed that from a technological perspective, Google’s Flu Trend system is just the beginning. And Thomas Malone, professor at M.I.T., was reported as saying: “I think we are just scratching the surface of what's possible with collective intelligence.”